Sex Therapy and Sexology in Canada

Sexology is the scientific study of human sexuality, and sex therapy is the clinical side of that field: a form of counselling that addresses sexual difficulties and the relationships around them. In Canada the two terms overlap in everyday use. Practitioners often come from psychology, social work, nursing, medicine or counselling backgrounds, and the rules governing professional titles differ from province to province.

Concerns that bring people to sex therapy

Practitioners describe a wide set of issues. They include vaginismus, which involves involuntary tightening of the muscles around the vagina, and dyspareunia, the medical term for painful intercourse. They also cover erectile difficulties and premature ejaculation, compulsive sexual behaviour, relationship strain, and worries about sexually transmitted infections. These are standard categories in sexual medicine, and many involve both physical and psychological factors, which is why therapy is frequently discussed alongside medical care.

Formats of care

Sex therapy is delivered in several ways. Common formats include individual and couples counselling, along with group sessions and topic workshops. Workshop subjects often include menopause, chronic illness and pain, and how parents discuss sex with children. Groups for people who have experienced sexual harm, and for their families, are also offered by some practices.

A sex-positive framework

Many practitioners describe their orientation as sex-positive, a term for approaches that treat sexuality as a normal part of human life and a possible source of confidence, communication and closeness, while recognizing that some clients arrive after experiences that left sex feeling frightening. Supporters of this framework argue that open, non-shaming discussion helps people understand their own responses. Critics have sometimes said that such language can downplay the distress some people feel about sex. Both views appear in professional debate.

Work with people who have offended sexually

Some clinicians work with people who have committed sexual offences, in outpatient or residential programs. Practitioners in this area differ on approach. Some argue that treatment programs often treat sex itself as a negative subject, while others emphasize risk management and accountability. Treatment of sexual offending is an active and contested area of forensic psychology, and views differ on which methods are most effective.

Sexual rights as human rights

Many sexologists and educators frame sexual rights as part of human rights, a position found in documents of international health bodies and in much sexual health education in Canada. Public speaking, media segments and books bring these topics to a general audience, and the credentials behind any given public figure differ, since titles are regulated differently across provinces.